colon cancer

Significance of Screening and Early Detection of Colorectal Cancer

Dr. Kudingila Radha Madhava
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Colorectal screening beginning at the age of 50, is extremely significant for the expedient diagnosis of colorectal cancer which advantageously results in successful treatment at the initial stage. Fecal Occult Blood Test, Stool DNA test, Sigmoidoscopy, Standard Colonoscopy and Virtual Colonoscopy are some of the ways to detect colorectal cancer.

Colorectal cancer stands as one of the most common types of cancers after skin, breast, and lung that is detected in both men and women as reported by the World Cancer Society. It is the second major contributor to the deaths caused by cancer in the United States alone.

However, colonoscopy is the diagnosis that can reveal about the growth of cancer at an early stage securing high chances of survival. It can be summarized as a person has 90 percent five-year survival rate if cancer gets detected before spreading to other parts of the body while the same can drop down to a mere 10 percent if goes undetected for a long time.

What is Colorectal cancer?

Colorectal cancer is generally found in people of old age (50 years or above). It starts either in the colon or rectum and, both have many things in common thus, they are grouped together. Cells start dividing with abnormal pace and eventually form a malignancy. Colorectal cancer starts with the formation of a tumor called polyps in the inner lining of the rectum or colon depending upon their area of origin. Albeit, not all polyps are cancerous and they all vary in characters and structures. Polyps are commonly categorized under:

  • Adenomatous polyps: These polyps have the tendency to change into cancer and are often termed as the pre-cancerous condition.
  • Hyperplastic polyps and inflammatory polyps: These are commonly found polyps but are not pre-cancerous.

How does colorectal cancer spread?

If cancer starts to develop in a polyp, it can spread through the adjacent walls of the colon or rectum. Out of many layers, Colorectal cancer develops in the innermost layer of the wall (of either colon or rectum) termed as the mucosa and can start growing outwards towards outer layers. As the cancer cell reaches to the wall it gets transferred to the lymph or blood vessels. Once cancer reaches these tiny vessels it takes no time in spreading to the rest of the body parts.

Symptoms of colorectal cancer

  • Frequent diarrhea or constipation
  • Blood in feces
  • Dark-colored stools
  • Blood gushing from the rectum during the bowel movement
  • Constant abdominal pain and bloating
  • Constant fatigue
  • Weight loss

diarrhea or constipation

Importance of colorectal screening

Colorectal cancer Is highly treatable if detected early. Screening finds the abnormal and cancerous growth that sometimes starts from inside the walls of the colon or rectum. There are no concrete symptoms of colorectal cancer at the early stage thus, screening plays a very crucial role in descending the risk of colorectal cancer. There are general indications that are observed initially, these signs are ignored often.

Methods of screening of colorectal cancer

Screening test for colorectal cancer begins at the age of 50 and continues till the age of 75, past this age bracket the screening of colorectal cancer is based on life expectancy, health status and many other factors related to the person. There are few methods of screening colorectal cancer that is generally used by the physicians:

1. Fecal Occult Blood Tests (FOBT):

There is slight bleeding in polyps during colorectal cancer which is not visible thus, FOBT is conducted to diagnose if there are any cancer cells that are growing within. Sometimes bleeding may also be due to hemorrhoids. There are many ways through which FOBT can be conducted. Sometimes patients are given home test kits by the doctor but most patients are asked to collect their stool samples of more than a day and send it to the doctor for analysis.

2. Stool DNA test (FIT-DNA):

It is a multitarget test that detects blood in the stool. When stool passes through the large intestine, cells that are present in the inner layer of the colon gets collected in it. The patient collects the sample of stool with the help of the kit which is further mailed to the laboratory for testing. There, the analysis of blood and DNA biomarkers is conducted to know if the cancer reports are negative or positive. In case the reports come out to be positive, the patient is asked to undergo Sigmoidoscopy or Colonoscopy.

3. Sigmoidoscopy:

In this test, a flexible tube attached to a lens is used for removing cancerous tissue. The tube is inserted into the rectum through anal opening and the air is pumped into the colon to expand the passage making the colon lining visible to the doctor. During this method, the abnormal growth that has formed over the time is extracted for biopsy.

4. Standard Colonoscopy:

In this method, colonoscopy is used for scrutinizing the condition of the colon and rectum. Just like sigmoidoscopy, the colonoscope is inserted through the anal opening into the rectum. Colonoscopy is conducted to extract those abnormal growths that are beyond the reach of Sigmoidoscopy. Patients have to undergo a thorough cleansing of the entire colon before the test. Patients are given sedatives during the process which help them in keeping throughout the procedure, which takes around 50 minutes to complete.

5. Virtual colonoscopy:

It is also known as computed tomography and it involves a scanner that takes a series of pictures of the colon and the rectum from outside the body. These pictures are then assembled by the computer which later helps the doctor in detecting the growth of polyps and formation of cancer tissue. Although the accuracy of both virtual and standard colonoscopy is similar, in virtual colonography, there are lesser complications as compared to standard colonoscopy.

Bowel preparation for colonoscopy

Colon has a size of approximately 6 feet and for accurate conduction of the colonoscopy procedure, the colon must be cleaned thoroughly. Physicians start bowel preparation and examination for the same before several days. Patients are given detailed guidelines and instructions about the cleansing preparation.

  • They are asked to drink a cleansing solution.
  • Apart from that, they are kept on laxatives or enemas. If the instructions are not followed exactly the procedure may not yield a satisfactory result and may require repetition.
  • To be on the safer side patients are put on a specific diet that includes the prohibition of consuming heavy acidic food, oily and spicy food, food with seeds etc.

Potential side effects of colon cleansing

There are several potential side effects that can happen at the time of bowel preparation for colonography due to the body’s defense mechanism

  • Nausea
  • Abdominal cramps
  • Dizziness
  • Dehydration
  • Certain Infection
  • Kidney failure in rare and extreme cases

Side effects of colonoscopy

Although the test is extremely helpful in finding abnormalities that are generally ignored and get undetected. There can be certain side effects that can happen post Colonoscopy.

  • Most common side effects of colonoscopy include cramps and abdominal swelling caused due to laxatives and air that is used to expand colon passage. But the good thing is that these symptoms are resolved without medication.
  • As the biopsy takes place during the procedure, the patient might observe some amounts of blood during bowel movements which may last for a few days.
  • There are chances of injury or infection through colonoscopy, although the chances are very low.

How often should the screening test be done?

Colon cancer screening is considered as a major part of a health checkup for people who are above the age of 50 years. There are certain tests that are needed to be done before the doctor advises about the frequency of screening test. But according to industry guidelines screening test should be conducted at a duration of every 9 to 10 years depending on the health of the person.

When to go under screening test?

There are various factors that are needed to be kept in mind before undergoing a screening test. The age of the patient, medical history, cons and pros of the test, preparation of the test, follow-up care and cost etc.

Timely diagnosis of colorectal cancer ensures higher survival rate. Therefore, it is necessary to look out for the symptoms from time to time and take immediate action if you found something suspicious.


Dr. Kudingila Radha Madhava

About the Author

Medical Oncologist
Dr. Kudingila Radha Madhava is a Medical Oncologist at Gleneagles Global Hospitals in Richmond Town, Bangalore. He has completed his MBBS from J.S.S Medical College, Mysore in the year 1990 and MD in General Medicine from Topiwala National Medical College and BYL Nair Charitable Hospital in the year 1995. Further, he pursued DNB in Medical Oncology from DNB board, New Delhi in 1997. He has received Fellowship of the Royal College of Radiologists in Clinical Oncology from University of London, the United Kingdom in the year 2005. Dr. Kudingila specializes in the treatments of Bile Duct Cancer, Colon Cancer, Ovarian Cancer, Neuroendocrine Tumors, Prostate Cancer, General Surgery, Throat Cancer, Rhabdomyosarcoma, Sarcoma, and Thyroid Cancer. He has a practicing experience of more than two and a half decades in the field of oncology treatments. Gleneagles Global Hospitals offers medical treatments in various specialties which includes Radiation Oncology, Surgical Oncology, Arthroscopy, Endoscopy, Gastroenterology, Cardiology, Diabetology, Lung transplantation, Liver transplantation, Paediatrics and Nephrology. Book a FREE appointment with Dr. Kudingila Radha Madhava. See Success rates, Contact Number.
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